Design Challenges in Creative Systems. Theories, Methods, and Practices for Sustainability and Inclusion.

This volume focuses on the dynamic systems of creativity and culture within the diverse fields of design, merging theoretical reflections, case studies, methodologies, technologies, tools, and original practices. The twelve essays adopt different viewpoints to consider the critical role of design in addressing sustainability and social inclusion in creative and cultural industries, positioning them as vital components of a broader design process that fosters local growth, revitalizes communities, and co-creates cultural, economic, and social values. In today's evolving global society, crises in productive cycles, amplified by the COVID-19 pandemic, have accelerated the need for change and influenced behaviors. Digital technologies have transformed the creative arts and media landscape, bridging the gap between designers and consumers and expanding possibilities in both real and virtual domains. Audience engagement is central to this reflection, aiming to increase interest in cultural heritage, promote innovative cultural experiences, and reach underrepresented groups, ensuring accessibility to a diverse audience. As a new era emerges with evolving forms of society, culture, economy, and politics, the book revisits concepts like 'sustainable culture,' 'inclusive sociality,' and 'participation' in cultural heritage as a common good. Proposing a long-term, holistic approach to the challenges of the Anthropocene Age, it highlights the importance of creative and cultural industries in local development and community engagement. It envisions new models of sociality and community concepts, seeing design, creativity, and culture as catalysts for continuous change and interaction. By adopting multidisciplinary approaches and innovative practices, the volume seeks to inspire new models for cultural engagement and community development, contributing to a more inclusive and sustainable future. It redefines issues like accessibility, multiculturalism, and inclusion, reshaping the social and political positioning of the current cultural system

Modelling the spatial interactions between workplace and residential location

The use of Multinomial Logit (MNL) models specification for the simulation of residential location have been often criticised due to the Independence of Irrelevant Alternatives hypothesis (IIA) which does not allow for the existence of spatial correlation between residential zones. Moreover, it is not clear when and to what extent the influence of the workplace zone and accessibility to employment affect the residential location choices made by households; in other word, whether the residing choice is conditional to the workplace, or vice versa; or if such choices (residence and work place) are joint. In this paper, Nested Logit (NL) and Cross-Nested Logit models of residential location choice are specified and compared to MNL, to investigate the existence of spatial correlation between different locations. Furthermore, different assumptions are tested, considering the choice of residential zone and the joint choice of residential zone and work place zone. The models were estimated for the urban area of Santander (Spain). The results indicate that the inclusion in the model specification, of the spatial correlation between zones fit the data significantly better. Home-work journey times were a statistically significant factor in household location choice, whereas accessibility to employment had the correct sign but it was not statistically significant

Modelling transport and real-estate values interactions in urban systems

This article presents hedonic Multiple Linear Regression models (MLR), Spatial Auto-Regressive hedonic models (SAR), Spatial autoregressive hedonic in the Error term Models (SEM) and spatial Durbin hedonic Models (SDM) to estimate houses price variations in metropolitan areas as a result of changing environmental and accessibility conditions. The goodness of fit of the different models has been compared along with a series of hypotheses about the performance of the specifications considering spatial relationships between observations. The case study for such analysis was the urban area of Santander (Spain). It has been observed the models which considered spatial dependence between observations offered a greater degree of fit in a scenario showing strong spatial correlation in MLR residuals. The SEM model combined with a Queen-Contiguity matrix provided a good fit to the data and at the same time presented significant parameters with theoretically coherent signs. This model estimated increases of 1.8% for each additional transit line present in the areas of housing, as well as a reduction of 1.1% in their prices for each additional minute in travelling time to the Central Business District. Closeness to the train stations, however, implied reductions in house prices

Universal versus risk factor screening for gestational diabetes mellitus

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The risk stratification of adverse neonatal outcomes in women with gestational diabetes (STRONG) study

Aims: To assess the risk of adverse neonatal outcomes in women with gestational diabetes (GDM) by identifying subgroups of women at higher risk to recognize the characteristics most associated with an excess of risk. Methods: Observational, retrospective, multicenter study involving consecutive women with GDM. To identify distinct and homogeneous subgroups of women at a higher risk, the RECursive Partitioning and AMalgamation (RECPAM) method was used. Overall, 2736 pregnancies complicated by GDM were analyzed. The main outcome measure was the occurrence of adverse neonatal outcomes in pregnancies complicated by GDM. Results: Among study participants (median age 36.8 years, pre-gestational BMI 24.8 kg/m2), six miscarriages, one neonatal death, but no maternal death was recorded. The occurrence of the cumulative adverse outcome (OR 2.48, 95% CI 1.59–3.87), large for gestational age (OR 3.99, 95% CI 2.40–6.63), fetal malformation (OR 2.66, 95% CI 1.00–7.18), and respiratory distress (OR 4.33, 95% CI 1.33–14.12) was associated with previous macrosomia. Large for gestational age was also associated with obesity (OR 1.46, 95% CI 1.00–2.15). Small for gestational age was associated with first trimester glucose levels (OR 1.96, 95% CI 1.04–3.69). Neonatal hypoglycemia was associated with overweight (OR 1.52, 95% CI 1.02–2.27) and obesity (OR 1.62, 95% CI 1.04–2.51). The RECPAM analysis identified high-risk subgroups mainly characterized by high pre-pregnancy BMI (OR 1.68, 95% CI 1.21–2.33 for obese; OR 1.38 95% CI 1.03–1.87 for overweight). Conclusions: A deep investigation on the factors associated with adverse neonatal outcomes requires a risk stratification. In particular, great attention must be paid to the prevention and treatment of obesity

Association of Genetic Markers with CSF Oligoclonal Bands in Multiple Sclerosis Patients

Objective:to explore the association between genetic markers and Oligoclonal Bands (OCB) in the Cerebro Spinal Fluid (CSF) of Italian Multiple Sclerosis patients.Methods:We genotyped 1115 Italian patients for HLA-DRB1*15 and HLA-A*02. In a subset of 925 patients we tested association with 52 non-HLA SNPs associated with MS susceptibility and we calculated a weighted Genetic Risk Score. Finally, we performed a Genome Wide Association Study (GWAS) with OCB status on a subset of 562 patients. The best associated SNPs of the Italian GWAS were replicated in silico in Scandinavian and Belgian populations, and meta-analyzed.Results:HLA-DRB1*15 is associated with OCB+: p = 0.03, Odds Ratio (OR) = 1.6, 95% Confidence Limits (CL) = 1.1-2.4. None of the 52 non-HLA MS susceptibility loci was associated with OCB, except one SNP (rs2546890) near IL12B gene (OR: 1.45; 1.09-1.92). The weighted Genetic Risk Score mean was significantly (p = 0.0008) higher in OCB+ (7.668) than in OCB- (7.412) patients. After meta-analysis on the three datasets (Italian, Scandinavian and Belgian) for the best associated signals resulted from the Italian GWAS, the strongest signal was a SNP (rs9320598) on chromosome 6q (p = 9.4×10-7) outside the HLA region (65 Mb).Discussion:genetic factors predispose to the development of OCB

Demand for environmentally friendly vehicles: A review and new evidence

Although the need for more environmentally friendly vehicles was recognized some decades ago, this new market has not yet established itself. Consumer behavior needs to be studied to ascertain when people will decide to purchase hybrid or electric vehicles rather than conventional ones. An in-depth review of the state-of-the-art has identified existing deficiencies and these are addressed in this paper, proposing a new approach that is applied to the case of Santander in Spain. Emphasis is placed on the role of citizens in researching the local market and their requirements with respect to such vehicles; our model assumes variability in user preferences, an utmost requirement as concluded from the literature review. Results suggest that the highest demand for cleaner vehicles would be achieved in two ways: firstly, by penalizing conventional vehicles in terms of costs/km; secondly, by providing incentives directed at lowering the purchasing price of hybrid and electric vehicles. Finally, as demand becomes more elastic, the preferred strategy should initially focus on hybrid vehicles

Breakthrough SARS-CoV-2 infections after COVID-19 mRNA vaccination in MS patients on disease modifying therapies during the Delta and the Omicron waves in Italy

Background In this study we aimed to monitor the risk of breakthrough SARS-CoV-2 infection in patients with MS (pwMS) under different DMTs and to identify correlates of reduced protection.Methods This is a prospective Italian multicenter cohort study, long-term clinical follow-up of the CovaXiMS (Covid-19 vaccine in Multiple Sclerosis) study. 1855 pwMS scheduled for SARS-CoV-2 mRNA vaccination were enrolled and followed up to a mean time of 10 months. The cumulative incidence of breakthrough Covid-19 cases in pwMS was calculated before and after December 2021, to separate the Delta from the Omicron waves and to account for the advent of the third vaccine dose.Findings 1705 pwMS received 2 m-RNA vaccine doses, 21/28 days apart. Of them, 1508 (88.5%) had blood assessment 4 weeks after the second vaccine dose and 1154/1266 (92%) received the third dose after a mean interval of 210 days (range 90-342 days) after the second dose. During follow-up, 131 breakthrough Covid-19 infections (33 during the Delta and 98 during the Omicron wave) were observed. The probability to be infected during the Delta wave was associated with SARS-CoV-2 antibody levels measured after 4 weeks from the second vaccine dose (HR=0.57, p < 0.001); the protective role of antibodies was preserved over the whole follow up (HR=0.57, 95%CI=0.43-0.75, p < 0.001), with a significant reduction (HR=1.40, 95%CI=1.01-1.94, p=0.04) for the Omicron cases. The third dose significantly reduced the risk of infection (HR=0.44, 95%CI=0.21-0.90,p=0.025) during the Omicron wave.Interpretation The risk of breakthrough SARS-CoV-2 infections is mainly associated with reduced levels of the virus-specific humoral immune response. Copyright (c) 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/

The Italian multiple sclerosis register

The past decade has seen extraordinary increase in worldwide availability of and access to several large multiple sclerosis (MS) databases and registries. MS registries represent powerful tools to provide meaningful information on the burden, natural history, and long-term safety and effectiveness of treatments. Moreover, patients, physicians, industry, and policy makers have an active interest in real-world observational studies based on register data, as they have the potential to answer the questions that are most relevant to daily treatment decision-making. In 2014, the Italian MS Foundation, in collaboration with the Italian MS clinical centers, promoted and funded the creation of the Italian MS Register, a project in continuity with the existing Italian MS Database Network set up from 2001. Main objective of the Italian MS Register is to create an organized multicenter structure to collect data of all MS patients for better defining the disease epidemiology, improving quality of care, and promoting research projects in high-priority areas. The aim of this article is to present the current framework and network of the Italian MS register, including the methodology used to improve the quality of data collection and to facilitate the exchange of data and the collaboration among national and international groups